Accepted for/Published in: JMIR Human Factors
Date Submitted: May 12, 2023
Date Accepted: Oct 5, 2023
Think-Aloud Testing of a Smartphone App for Lifestyle Change among Persons at Risk of Type 2 Diabetes: Usability Study
ABSTRACT
Background:
Type 2 diabetes mellitus (DM2) is a leading cause of morbidity and mortality worldwide and is considered a global epidemic. Despite the growing evidence on the effectiveness of mHealth interventions in the management of DM2, the evidence on the effect of mHealth interventions in prevention of DM2 is sparse. Therefore, we have developed an app aiming to promote initiation of behavioral change and adherence to healthy behavior. Before commencing a small scale randomized controlled trial (RCT) to assess the feasibility of using an app for initiation and adherence of healthy behavior in people at risk of DM2, testing the usability of the app in the target population is warranted.
Objective:
The aim of this study was to assess the usability of an app among people at risk of DM2.
Methods:
A qualitative study with the use of a Think Aloud (TA) procedure was conducted from April to November 2022. The TA procedure consisted of ten problem-solving tasks and a semi structured interview which was carried out after the tasks. These interviews served to gain more in-depth knowledge of the users experience of the problem-solving tasks. The TA-sessions and the post-activity interviews were recorded and transcribed verbatim, and the data was coded and analyzed following the principles of thematic analysis.
Results:
Seven people at risk of DM2 with a median age of 66 years (range 41-75 years) participated in the study. The analysis resulted in the following three themes: (1) User interface design of the app; (2) Navigation strategy and functionality; and (3) Suggestions for improvements of the functionality of the app.
Conclusions:
Overall, the participants were satisfied with the usability of the app. Through the TA-sessions, real time perspective on the appeal, relevance and utility of the app were gained. Only minor changes to the functionality of the prototype app were reported as necessary to improve the usability of the app. Points of guidance from the participants in the study gave been adopted and incorporated into the final design of the app now being assessed for feasibility in a small-scale RCT.
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